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New Indian Express
12 hours ago
- Health
- New Indian Express
MEDISEP govt insurance scheme to continue in present form till new deal
THIRUVANANTHAPURAM: The MEDISEP insurance scheme for government employees and pensioners will continue in its current format for the time being. The government's agreement with Oriental Insurance, which ends on June 30, 2025, has been extended until a new arrangement is finalised. Recently, an expert committee submitted major recommendations to make the scheme more attractive. At present, Oriental Insurance is the service provider and the annual premium for a beneficiary is Rs 5,664 including 18% GST. The government makes advance payment of the premium amount to the insurance company in four installments a year. This amount will be recovered from the salary or pension of beneficiaries in 12 installments. The agreement with the insurance company is from July 2022 to June 30, 2025. It is learnt that the expert committee has recommended to hike the monthly premium amount from Rs 500 to Rs 750 and to enhance the coverage to Rs 5 lakh. Another recommendation is to collect premiums from only one person in a family having more than one government employee. Employees should be given the option to stay away from the scheme. The package should be revised to attract more private hospitals, especially speciality hospitals, to join the scheme, it said. At present, the scheme is mandatory for employees and pensioners. The government has directed Additional Chief Secretary (Finance) K R Jyothilal to take further steps on the report. The health secretary will also be asked to submit recommendations. New scheme to offer better packages, says minister Finance Minister K N Balagopal said the MEDISEP's second edition will be more attractive. 'We want more hospitals, especially major private institutions, to join the scheme. The treatment packages will be revised for this,' he told TNIE. On whether the premium would see an increase, he said: 'The present rates were fixed some three years ago. A decision on increasing the premium would be taken after consultations with stakeholders.' The minister said the insurance provider for the next edition will be selected through a fair and transparent bidding process. At a glance Claims approved (From Jan 1, 2025 to June 6) Total claims: 10.18 lakh Amount: Rs 1,863.22 crore Private hospitals Claims: 9.43 lakh Amount: Rs 1,745.36 crore Government hospitals Claims: 74,000 Amount: Rs 117.86 crore Total beneficiaries covered Employees and pensioners: 11.44 lakh Dependents: 19.49 lakh
New Indian Express
27-04-2025
- Health
- New Indian Express
Uncertainty looms over continuation of Medisep scheme
THIRUVANANTHAPURAM: Uncertainty prevails over the future of Medisep, the health insurance scheme for government employees and pensioners, as the expert committee appointed by the state government to recommend revisions is yet to submit its report. The Oriental Insurance is the insurance provider and, under the present scheme, the annual premium for a beneficiary is Rs 5,664, including 18% GST. The government makes an advance payment of the premium amount to Oriental Insurance in four instalments a year. The government will retrieve this amount from the salary or pension of beneficiaries in 12 instalments. Earlier, the insurance provider had asked the government to hike the premium. This demand and the criticism by employees' organisations prompted the government to appoint an expert committee to submit recommendations on revamping the scheme. The major criticism by employees was that prominent hospitals are not partnering with the scheme. Lack of standard treatment packages and inclusion of impractical rates were also raised. The agreement with the Oriental insurance ends on June 30, 2025, and the government will have to decide on a premium hike to renew it. Started in July 2022, the scheme has 30.92 lakh beneficiaries. Of the 11.43 lakh direct beneficiaries, 5.53 lakh are government employees and 5.90 lakh are pensioners. Besides 19.48 lakh dependants of employees and pensioners are also part of the scheme. As many as 628 hospitals are partnering with the scheme. Of them, 471 are private hospitals and 145 are government hospitals. Until March, 9.49 lakh claims worth `1,849.89 crore were approved. Meanwhile, Finance Minister K N Balagopal said the government wants to continue the programme. 'We are waiting for the expert committee report. It will have recommendations on different aspects like premium, bidding etc,' he said.
